Radionecrosis: hemorrhagic

Case contributed by Assoc Prof Frank Gaillard

Presentation

Prior history of nasopharyngeal cancer.

Patient Data

Age: Adult
Gender: Male
MRI

Both temporal lobes demonstrate cystic hemosiderin lined change. On the right there is abundant vasogenic edema. 

Case Discussion

This patient had had previous radiotherapy for nasopharyngeal carcinoma, and now demonstrates typical, albeit pronounced, changes of radionecrosis of the temporal lobes. It is important to note how variable the appearance can be even in the one patient from the one exposure. 

CBV and MRS are helpful in demonstrating non-tumor features; low CBV and flat MRS +/- lipid lactate respectively. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.